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Keeton Construction Inc; 2017-10-27; PWM18-51GS
RECORDED REQUESTED BY CITY OF CARLSBAD DOC# 2018-0278077 111111111111 lllll 111111111111111 lllll lllll lllll 11111111111111111111111 Jul 09, 2018 11 :01 AM OFFICIAL RECORDS Ernest J. Dronenburg, Jr, AND WHEN RECORDED PLEASE MAIL TO: SAN DIEGO COUNTY RECORDER FEES $0.00 (SB2 Atkins: $0.00) City Clerk City of Carlsbad 1200 Carlsbad Village Drive Carlsbad, California 92008 PAGES: 2 Space above this line for Recorder's use. PARCEL NO: NOTICE OF COMPLETION Notice is hereby given that: 208-010-38-00 1. The undersigned is owner of the interest or estate stated below in the property hereinafter described. 2. The full names of the undersigned are City of Carlsbad, a municipal corporation. 3. The full address of the undersigned is 1200 Carlsbad Village Drive, Carlsbad, California 92008. 4. The nature of the title of the undersigned is: In fee. 5. A work or improvement on the property hereinafter described was completed on May 21, 2018. 6. The name of the contractor for such work or improvement is Keeton Construction, Inc. 7. The property on which said work or improvement was completed is in the City of Carlsbad, County of San Diego, State of California, and is described as follows: Project Name: Fire Station No. 3 Concrete Removal and Replacement. 8. The street address of said property is 3465 Trailblazer Way, in the City of Carlsbad. VERIFICATION OF CITY CLERK I, the undersigned, say: I am the City Clerk of the City of Carlsbad, 1200 Carlsbad Village Drive, Carlsbad, California, 92008 of said City on -........1} 4 r,0 I '-/ . 2o__ff?_, accepted the above described work as completed and ordered that a Notice of Completion be filed. I declare under penalty of perjury that the foregoing is true and correct. Executed on 0l:<-Nb.~ , 201JL, at Carlsbad, California. \]OFCARISBADL mi ~ .. //7/c~~ ~ARBARA ENGLESON V City Clerk \\files01v\Departments\Public Works\PW Common\00_PW Formally Approved Documents\NOCs and APls\NOC (Public and Private)-revised 2018-02-27.doc CITY OF CARLSBAD ACCEPTANCE OF PUBLIC IMPROVEMENTS COMPLETION OF PUBLIC IMPROVEMENTS Keeton Construction, Inc has completed the contract work required for Fire Station No. 3 Concrete Removal and Replacement. City forces have inspected the work and found it to be satisfactory. The work consisted of: IMPROVEMENTS (Specify if City or CMWD) Removal and Replacement of Concrete Drives & Walks $40,868 CERTIFICATION OF COMPLETION OF IMPROVEMENTS VALUE ~ginee~/'}L\ __,.;-a--'-'t~-·~/~ ____ _ CITY MANAGER'S ACCEPTANCE OF PUBLIC IMPROVEMENTS The construction of the above described contract is deemed complete and hereby accepted. The City Clerk is hereby authorized to record the Notice of Completion and release the bonds in accordance with State Law and City Ordinances. The City of Carlsbad is hereby directed to commence maintaining the above described improvements. A APPROVED AS TO FORM: CELIA BREWER, City Attorney By~~ DeptyCity Attorney Q \Public Works\PW Common\Agreements & Contracts\Contracts\2018 Contracts\MINOR PUBLIC WORKS\Keeton Construction\API (Public Works). revised 2018-02-15.doc CITY OF CARLSBAD CONTRACT CHANGE ORDER TRANSMITTAL -C/O # 1 Project: 40031, Fire Station No. 3 Concrete Removal and Replacement Date Routed: Initials: To: Department Head Construction Management & Inspection (RETURN TO JOHN MAAS HOFF ONCE FULLY EXECUTED) Executive Summary: On October 12, 2017, the Public Works Director awarded Contract No. PWM18-51 GS for the amount of $42,753 to Keeton Construction, Inc., for removing and replacing failing concrete flatwork at Fire Station 3. The Public Works Director is authorized to execute change orders up to $45,000. Sufficient funds are available in the project budget to cover this change order COST ACCOUNTING SUMMARY: Original contract amount $42,753.00 Total amount this C/O -$1,885.00 Total amount of previous C/O's $0.00 Total C/O's to date -$1,885.00 New Contract Amount $40,868.00 Total C/O's as % of original contract -4.41 % Contingency amount encumbered $0.00 Contingency increase/ decrease $0.00 Contingency Subtotal $0.00 Total Cf O's to date -$1,885.00 Contingency balance $1,885.00 Reasons for changes: Item 1: The amount of concrete that needed to be removed and replaced was slightly less than the estimated quantit in the ori inal contract. CITY OF CARLSBAD CONTRACT CHANGE ORDER NO. 1 PROJECT: # 40031, Fire Station No. 3 Concrete Removal and Replacement CONTRACT NO. 40031 ACCOUNT NO. 320 7o00 C\ o(oo Yob31 9 O(i,(o CONTRACTOR: Keeton Construction, Inc. ADDRESS: 41635 Enterprise Circle N. Ste. A Temecula, CA 92590 P.O. NO. P13L\'\OS° The Contractor is directed to make the following changes as described herein. Changes shall include all labor, materials, equipment, contract time extension, and all other goods and services required to implement this change. Payment stated on this change order includes all charges, direct or indirect, arising out of this additional work including charges for field overhead, extended home office overhead, delays, disruptions, cumulative impacts, loss of efficiency, extended equipment costs and overtime premium costs and is expressly agreed between the City and the Contractor to be the complete and final costs hereof. The requirements of the specifications, where pertinent and not in conflict with this change order, shall apply to these changes. Pursuant to the Standard Specifications for Public Works Construction, perform the following: Item 1 : The total square footage of concrete removed and replaced was less than the contracted amount. The thickness of portions of the concrete that was removed and replaced was thicker than represented. The total contract amount is being adjusted to account for reduced square footage and increased thickness. Revised contact amount is $40,868.00. Total decrease in contract amount ................................................... ($1,885.00) TIME FOR COMPLETION OF ALL WORK UNDER THIS CONTRACT SHALL NOT BE INCREASED AS A RESULT OF THIS CHANGE ORDER. RECOMMENDED BY: APPROVED BY: - CONTRACTOR DEPARTMEN DISTRIBUTION: INSPECTION FILE (ORIGINAL), PURCHASING, CONTRACTOR Digitally signed by Robert Kelley Date: 2018.03.12 08:23:09 -07'00' (DATE) (DATE) PWM18-51GS CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT FIRE STATION NO. 3 CONCRETE REMOVAL AND REPLACEMENT; CONT. NO. 40031 This agreement is made on the 2..-1 ~ day of oc..A-t \:,e,r , 2017, by the City of Carlsbad, California, a municipal corporation, (hereinafter called "City"), and Keeton Construction, Inc., a California corporation whose principal place of business is 41635 Enterprise Circle North, Ste. A, Temecula, CA 92590 (hereinafter called "Contractor"). City and Contractor agree as follows: DESCRIPTION OF WORK. Contractor shall perform all work specified in the Contract documents for the project described by these Contract Documents (hereinafter called "Project"). PROVISIONS OF LABOR AND MATERIALS. Contractor shall provide all labor, materials, tools, equipment, and personnel to perform the work specified by the Contract Documents unless excepted elsewhere in this Contract. CONTRACT DOCUMENTS. The Contract Documents consist of this Contract, exhibits to this Contract, Contractor's Proposal, the Plans and Specifications, the General Provisions, addendum(s) to said Plans and Specifications, and all proper amendments and changes made thereto in accordance with this Contract or the Plans and Specifications, all of which are incorporated herein by this reference. When in conflict, this Contract will supersede terms and conditions in the Contractor's proposal. LABOR. Contractor will employ only skilled workers and abide by all State laws and City of Carlsbad Ordinances governing labor. GUARANTEE. Contractor guarantees all labor and materials furnished and agrees to complete the Project in accordance with directions and subject to inspection approval and acceptance by: Ron Haugland (City Project Manager) WAGE RATES. The general prevailing rate of wages for each craft or type of worker needed to execute the Contract shall be those as determined by the Director of Industrial Relations pursuant to Sections 1770, 1773 and 1773.1 of the Labor Code. Pursuant to Section 1773.2 of the Labor Code, a current copy of the applicable wage rates is on file in the Office of the City Engineer. Contractor shall not pay less than the said specified prevailing rates of wages to all workers employed by him or her in execution of the Contract. Contractor shall be responsible for insuring compliance with provisions of section 1777.5 of the Labor Code and section 4100 et seq. of the Public Contracts Code, "Subletting and Subcontracting Fair Practices Act." The City Engineer is the City's "duly authorized officer" for the purposes of section 4107 and 4107 .5. The provisions of Part 7, Chapter 1, of the Labor Code commencing with section 1720 shall apply to the Contract for work. A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, unless currently registered and qualified to perform public work pursuant to Section 1725.5. This project is subject to compliance monitoring and enforcement by the Department of Industrial Relations. Contractor and any subcontractors shall comply with Section 1776 of the California Labor Code, which generally requires keeping accurate payroll records, verifying and certifying payroll records, and making them available for inspection. Contractor shall require any subcontractors to comply with Section 1776. Fire Station No. 3 Concrete Removal and Replacement Cont No. 40031 Page 1 of 8 City Attorney Approved 9/27 /16 PWM18-51GS FALSE CLAIMS. Contractor hereby agrees that any contract claim submitted to the City must be asserted as part of the contract process as set forth in this agreement and not in anticipation of litigation or in conjunction with litigation. Contractor acknowledges that California Government Code sections 12650 et seq., the False Claims Act, provides for civil penalties where a person knowingly submits a false claim to a public entity. These provisions include false claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of the information. The provisions of Carlsbad Municipal Code sections 3.32.025, 3.32.026, 3.32.027 and 3.32.028 pertaining to false claims are incorporated herein by reference. Contractor hereby acknowledges that the filing of a false claim may subject the Contractor to an administrative debarment proceeding wherein the contractor may be prevented from further bidding on public contracts for a period of up to five years and that debarment by another jurisdiction is grounds for the City of Carlsbad to disqualify the Contractor or subcontractor from participating in contract bidding. Signature: Print Name: REQUIRED INSURANCE. The successful contractor shall provide to the City of Carlsbad, a Certification of Commercial General Liability and Property Damage Insurance and a Certificate of Workers' Compensation Insurance indicating coverage in a form approved by the California Insurance Commission. The certificates shall indicate coverage during the period of the contract and must be furnished to the City prior to the start of work. The minimum limits of liability insurance are to be placed with California admitted insurers that have a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California's List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best's Key Rating Guide of at least "A:X''; OR an alien non-admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report. Commercial General Liability Insurance of Injuries including accidental death, to any one person in an amount not less than ........ $1,000,000 Subject to the same limit for each person on account of one accident in an amount not less than ....... $1,000,000 Property damage insurance in an amount ofnot less than ........ $1,000,000 Automobile Liability Insurance in the amount of $1,000,000 combined single limit per accident for bodily injury and property damage. In addition, the auto policy must cover any vehicle used in the performance of the contract, used onsite or oftsite, whether owned, non-owned or hired, and whether scheduled or non- scheduled. The automobile insurance certificate must state the coverage is for "any auto" and cannot be limited in any manner. The above policies shall have non-cancellation clauses providing that thirty (30) days written notice shall be given to the City prior to such cancellation. The policies shall name the City of Carlsbad as an additional insured. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY. Workers' Compensation limits as required by the California Labor Code. Workers' Compensation will not be required if Contractor has no employees and provides, to City's satisfaction, a declaration stating this. BUSINESS LICENSE. The Contractor and all subcontractors are required to have and maintain a valid City of Carlsbad Business License for the duration of the contract. Fire Station No. 3 Concrete Removal and Replacement Cont No. 40031 Page 2 of 8 City Attorney Approved 9/27 /16 PWM18-51GS INDEMNITY. The Contractor shall assume the defense of, pay all expenses of defense, and indemnify and hold harmless the City, and its officers and employees, from all claims, loss, damage, injury and liability of every kind, nature and description, directly or indirectly arising from or in connection with the performance of the Contract or work; or from any failure or alleged failure of Contractor to comply with any applicable law, rules or regulations including those related to safety and health; and from any and all claims, loss, damages, injury and liability, howsoever the same may be caused, resulting directly or indirectly from the nature of the work covered by the Contract, except for loss or damage caused by the sole or active negligence or willful misconduct of the City. The expenses of defense include all costs and expenses including attorneys' fees for litigation, arbitration, or other dispute resolution method. JURISDICTION. The Contractor agrees and hereby stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this agreement is San Diego County, California. Start Work: Contractor agrees to start within fifteen (15) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within forty five (45) working days after receipt of Notice to Proceed. CONTRACTOR'S INFORMATION. KEETON CONSTRUCTION, INC., a California corporation Ill Ill Ill Ill Ill Ill Ill (name of Contractor) 495492 (Contractor's license number) B -General Building Contractor 7/31/18 (license class. and exp. date) 1000006227 (DIR registration number) 6/30/18 (DIR registration exp. date) Fire Station No. 3 Concrete Removal and Replacement Cont No. 40031 41635 Enterprise Circle North, Ste. A (street address) Page 3 of 8 Temecula, CALIFORNIA 92590 (city/state/zip) 951-296-6400 (telephone no.) 951-296-2808 (fax no.) robert@keetonconstruction.com (e-mail address) City Attorney Approved 9/27/16 PWM18-51GS AUTHORITY. The individuals executing this Agreement and the instruments referenced in it on behalf of Contractor each represent and warrant that they have the legal power, right and actual authority to bind Contractor to the terms and conditions of this Agreement. CONTRACTOR KEETON CONSTRUCTION, INC., a California corporation By· ·~''/ , : : __ jj_~~t?'~. -·--E~~~ (s/n here) rtJf!c1l:1!L£Llf/i [k;JFcr MlfNl/6e'IL (p · t name/title) By: (sign here) (print name/title) CITY OF CARLSBAD, a municipal corporation of the State of California By: r A/~ 1111 . t l . -- Elaine Lu key~ Works Director as authorized by the City Manager ( A7i1EST: ,... ~ ·-/ -, · li.L'dbn tv17f2u., BARBARA ENGLESON City Clerk If required by City, proper notarial acknowledgment of execution by Contractor must be attached. !.f.E. corporation, Agreement must be signed by one corporate officer from each of the following two groups: Group A Chairman, President, or Vice-President Group B Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CELIA A. BREWER, City Attorney BY: -~---'-===---=-~--=-=L-~-_ Deputy City Attorney Fire Station No. 3 Concrete Removal and Replacement Cont No. 40031 Page 4 of 8 City Attorney Approved 9/27 /16 MINUTES OF THE DIRECTORS AND SHAREHOLDERS OF Keeton Construction Co., Inc. Pursuant to waiver of notice (copies) of which are attached). An annual meeting of the Directors and Shareholders of the above corporation was held on March 27, 2017 at 11 :30 AM at the corporation's place of business. The purpose of the meeting: was to elect directors, to elect officers, to establish the CEO's salary for the coming year, arid to authorize other corporate actions. I. QUORUM. A quorum was declared present based on the presence of the following Directors: Bruce G. Keeton and Lena D. Keeton and the following Shareholders who were Present or represented by proxy as follows: -Shareholder: Bruce G. Keeton Number of Shares: 96 The Shareholder was represented in person. The following corporate actions were taken by appropriate motions duly made, seconded, and adopted by the unanimous vote of the Directors and Shareholders intitled to vote (unless a higher voting approval is stated). II. ELECTION OF CHAIRPERSON AND SECRETARY. Bruce G. Keeton was appointed chairperson of the meeting, and Bruce G. Keeton was appointed as secretary to prepare a record of the proceedings. III. ELECTION OF DIRECTORS. The following persons were elected as Directors for the terms provided in the bylaws: Name: Term: Address: Name: Term: Address: Bruce G. Keeton Until the next annual meeting of Shareholders 7011 Via Mariposa Norte Bonsall, California 92003 Lena D. Keeton Until the next annual meeting of Shareholders 7011 Via Mariposa Norte Bonsall, California 92003 IV. ELECTION OF OFFICERS. The following Officers were elected: Name: Bruce G. Keeton Office: President Address: 7011 Via Mariposa Norte Bonsall, California 92003 Name: Bruce G. Keeton Office: Secretary Address: 7011 Via Mariposa Norte Bonsall, California 92003 Name: Bruce G. Keeton Office: Chief Financial Officer Address: 7011 Via Mariposa Norte Bonsall, California 92003 Name: Bruce G. Keeton Office: Vice-President Address: 7011 Via Mariposa Norte Bonsall, California 92003 V. APPROVAL OF ACTIONS SECTION. The actions and undertakings of the Directors. Officers, Employees, and Agents of the corporation were approved with respect to: All actions subsequent to the last meeting of the Board of Directions and Shareholders. Compensation paid to the Officers during the past year. Contribution of $0.00 to corporation retirement plan during the past year, for the year ended February 28, 2017. Selection during the past year of Covell & Hogan, Certified Public Accountant, to perform the corporation's financial statement audit for the year ended February 28, 2017. Add Chad Azevedo (working at the Lake Elsinore Motorsports Track) to Keeton's payroll but to be reimbursed biweekly by Keeton Holdings, LLC. Transfer monies as necessary between all of our bank accounts. Bob Kelley can sign any and all documents pertaining to any but not limited to contracts, change orders, bids, bonds, pulling permits etc. Dan Dodge resigned on September 5, 2015 VI. FINANCIAL STATEMENTS PRESENTATION. The financial statements for the year ending February 29, 2016, as prepared by the corporation's Accountant(s), Covell & Hogan, LLP Certified Public Accountant, were approved. VII. SALARIES. Salaries for Officers and other employees were established as follows: Name: Bruce G. Keeton Title: Chief Executive Officer Amount: $1,500,000.00 per year for the year ending February 28, 2018. VIII. BORROWING RESOLUTION: The corporation was authorized to borrow such amounts as the Officers deem advisable from any lending institution selected by the officers. The Officers are authorized to take all actions and to sign all documents reasonably needed to carry out this loan transaction. IX. AUTHORIZTION OF CORPORATE ACTION. The Officers were authorized to take all actions and to sign all documents reasonably needed to: Payment of CEO salary. The directors, after citing their knowledge of comparable CEO salaries in other closely held general contracting companies; and also citing Mr. Keeton's education, years of experience, ability to serve as Chief Executive Officer, Secretary, and Chief Financial Officer of a complex business, long hours and extra days worked, expertise in guiding the corporation to high income and growth of retained earnings; established the salary of Bruce G. Keeton at$1,500,000 for the year ending February 28, 2018, and directed the Officers to pay the salary in one or more payments. There being no further business, the meeting was duly adjourned. Bruce G. Kefeton Director and Shareholder Waiver of Notice of a Meeting of the Board of Directors and Shareholders of Keeton Construction Co., Inc. The undersigned Board of Directors and Shareholders of the above corporation hereby waive(s) notice of the annual meeting of the Board of Directors and Shareholders to be held on March 28, 2018, at 11 :30 AM, at the corporation's principal office. The undersigned further consent to the transaction of any business, in addition to the business stated above, that my come before the meeting. Bruce G. Keeton Director and Shareholder Date ? -2. "1--) J: ~P-~ Lena D. Keeton Director Date 3/2-t/('t- 7 I CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT r\ notary public or other officer completing this certificate verifies only the idcntitv of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California Count,· of Riverside -------------- who proved to me on the basis of \' eYidence to be the person(s) whose name(s) is/ arc subscribed to the within instrument and acknowledged to me that he/she/ the\' executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the pcrson(s), or the entity upon behalf of which the person(s) acted, executed the instrument. is true and correct. \XTfNESS MY HAND AND OFFICIAL SEAL. (\ llintw ,NiAt\illii~~ Signature of :\otan· Public I (Notan· Seal) OPTIONAL INFORMATION }he ack1101der{w11t11! ro11t"i11cd 11·ithi11 this dom11M1I is i11 accordt11m· ll'ilh <.,J/1/omid !{Ill'. _ -lnr ccrtifi,,1/r o/ llclrn01vlal.~mm1! pt1j1mJll'd 11-ithi11 !he .\!air o/ C1li/omi{{ shall 11st the pm'l'di1;2, 11•01-di111; j)//l:fl/dJJ/ lo CJri! Code ser/1011 1189. An acknowledg- n1ent c:wnot be affixed to a docun1ent sent by mail or otherwise delivered to a notary public, including electronic means, whereby the signer did not personally ;ippear before the notary public, even if the signer is known by the notary public. In addition, the correct not;irial wording can only be signed and scaled by a notary public. The seal and signature cannot be affixed to a docwnent without the correct notarial wording. DESCRIPTION OF ATTACHED DOCUMENT fJJn00v ?t1b~r1VUt~ Cort~« (Title of dornmcnt) "'.\u1nbcr of Pages ___ _ (including ackno,, lcdgn1cnt) Document Date \IMXV Jf.WARDALE 925.786.8909 \V\\w.TotallyNotary.nct CAPACITY CLAIMED BY SIGNER Individual Corporate Officer Partner :\trorne\'-ln-f'act Trustee ( lther: PWM18-51GS EXHIBIT A LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR Set forth below is the full name and location of the place of business of each sub-contractor whom the Contractor proposes to subcontract portions of the Project in excess of one-half of one percent of the total bid, and the portion of the Project which will be done by each sub-contractor for each subcontract. NOTE: The Contractor understands that if it fails to specify a sub-contractor for any portion of the Project to be performed under the contract in excess of one-half of one percent of the bid, the contractor shall be deemed to have agreed to perform such portion, and that the Contractor shall not be permitted to sublet or subcontract that portion of the work, except in cases of public emergency or necessity, and then only after a finding, reduced in writing as a public record of the Awarding Authority, setting forth the facts constituting the emergency or necessity in accordance with the provisions of the Subletting and Subcontracting Fair Practices Act (Section 4100 et seq. of the California Public Contract Code). If no subcontractors are to be employed on the project, enter the word "NONE." SUBCONTRACTORS Portion of Project to Business Name and Address DIR Registration be Subcontracted Concrete Verdin Concrete, Inc. 5487 Sunset Ridge Dr. Riverside, CA 92509 Total% Subcontracted: 100% Fire Station No. 3 Concrete Removal and Replacement Cont. No. 40031 No. 1000012122 Page 5 of 8 License No., %of Classification & Total Expiration Date Contract 780587 Exp 3/31/18 100% City Attorney Approved 9/27/16 EXHIBIT B Fire Station No. 3 3465 Trail Blazer Way Carlsbad, CA 92010 Concrete Removal and Replacement PWM18-51GS Remove and replace concrete sidewalk and response drive as noted in yellow on sheet A-1.1 (attached). Subgrade shall be flooded and presoaked for a minium of 2 days. New sidewalk shall be 5" thick with #3 rebar at 24" both ways and dowel into adjacent concrete. New response drive shall be 9" thick with #4 rebar at 18" both ways and dowel into adjacent concrete. Patch curbs in variuos locations. All work to be done in accorcance with original plans and specifications except as noted above. JOB QUOTATION ITEM UNIT QTY DESCRIPTION PRICE NO. 1 LS 1 General Conditions $2,500 2 LS 1 Bonds and Insurance $4,737 3 SF 2600 Removal and Replacement of Concrete Sidewalk $35,516 TOTAL* $42,753 *Includes taxes, fees, expenses and all other costs. Fire Station No. 3 Concrete Removal and Replacement Cont. No. 40031 Page 6 of 8 City Attorney Approved 9/27 /16 Exhibit "B" ,/ '-("7 / \: ', v"',. ''-, /,. ,/,,·.,. ,· ·>,,,><,(>> / '/ / >,. \(/. / 'J >·:_;\ ·,,//_. / ,' )\ ',,. /'. ,,/··,, /', / {,// _/ / ////·')., --.,.,' ;/ / -/ ·><:, '··<<. /. , (/.---, './.·: °"<'./· /. / <. F / / '·.,._ 'v / />/)·, / ·,,,_ '~ ·,.· // '-., / / ''</)._ <.t/ // /, / / C ... .-r ' " 11 I '.~ I i,\\ '\,, \ . · .. ~-~ /'"'', . '\ (<~:."\\ '\) .,\~_:_.))' ii "'· ... ,,..,,..,~ -F-~ 'f. r--r_ ·1 .·~:~-:~·:;·~: ::"::··· ~cj ,,.,..,,,,.,-~""""'· .. 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PAA"""°' CO!Cfl [IEMQW$IUAT9UUIH)P ... ,1 ;1Ul,SCEUl.13 rM>.ECl'!XWIIIWCTDl$1G,_lift l:fo.U ACa:S$1ll£amtl'Wi,IIU!h\-13 I COIOmMA!ollGl&WM.C.i:e l ~OIIM'l!Q 00,,,,111.1!!.!wmcN'EJlll.tiWfm f-!Efl 'l 'ICEASllt"J ,B,.T.HOW.OMWN.S ""81\Tl:JNCCffllQLU',$£,l~~ \lliCll0IJTHIIW 'IW',ltli O'l,.DIIK/l'l'Q GUMlTER,teEIWlBIClllA\IIMlS ~MFW!t~IH:tll,I,.\~ SAll)(lllfj1t/lC8'roft .1'E.EC!'4A. 'iflPUU;W0CIW«'iC.S CONOf£Nrpl!Qlrl,18T~IJ MaA11Q1;1Etti..sncmwM10 "'1JttSl"kll'Kl,PMITEOl'Ml~UJrlO. l'Yf' (;Al HOSE~UOMl,IElKETA.1• lNCJFMIIHU,Dw:R; 7S ,5, [E ~ 6 ~°'"'"'(eri O!SCIU~t!ON l'l.£\•iSl(1f,19 a,o,.r,:o~u1seo.:.£ 1'•20"-0'I PJIOJEClN\Jlt8El'I 111>10[! ARCHITECTURAL SITE PLAN EB'® . '======g I s1TE PLAN I ,.,,.. j s I REFERENCE NOTES I 4 11 :;:-;;~ A-1 .1 I; Bond No.: PB 115104 00717 Premium: $616.00 -premium is based on 100% of the final contract amount - PWM18-51GS EXHIBITC LABOR AND MATERIALS BOND WHEREAS, the City Council of the City of Carlsbad, State of California, has awarded to Keeton Construction, Inc., a California corporation (hereinafter designated as the "Principal"), a Contract for: FIRE STATION NO. 3 CONCRETE REMOVAL AND REPLACEMENT CONTRACT NO. 40031 in the City of Carlsbad, in strict conformity with the drawings and specifications, and other Contract Documents now on file in the Office of the City Clerk of the City of Carlsbad and all of which are incorporated herein by this reference. WHEREAS, Principal has executed or is about to execute said Contract and the terms thereof require the furnishing of a bond, providing that if Principal or any of its subcontractors shall fail to pay for any materials, provisions, provender or other supplies or teams used in, upon or about the performance of the work agreed to be done, or for any work or labor done thereon of any kind, the Surety on this bond will pay the same to the extent hereinafter set forth. NOW, THEREFORE, WE, Keeton Construction, Inc., a California corporation, as Principal, (hereinafter designated as the "Contractor"), and Philadelphia Indemnity Insurance Company as Surety, are held firmly bound unto the City of Carlsbad in the sum of FORTY TWO THOUSAND SEVEN HUNDRED FIFTY THREE Dollars ($42,753), said sum being an amount equal to: One hundred percent (100%) of the total amount payable under the terms of the Contract by the City of Carlsbad, and for which payment well and truly to be made we bind ourselves, our heirs, executors and administrators, successors, or assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH that if the Contractor or his/her subcontractors fail to pay for any materials, provisions, provender, supplies, or teams used in, upon, for, or about the performance of the work contracted to be done, or for any other work or labor thereon of any kind, consistent with California Civil Code section 9100, or for amounts due under the Unemployment Insurance Code with respect to the work or labor performed under this Contract, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the contractor and subcontractors pursuant to section 13020 of the Unemployment Insurance Code with respect to the work and labor, that the Surety will pay for the same, and, also, in case suit is brought upon the bond, reasonable attorney's fees, to be fixed by the court consistent with California Civil Code section 9554. This bond shall inure to the benefit of any of the persons named in California Civil Code section 9100, so as to give a right of action to those persons or their assigns in any suit brought upon the bond. Surety stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract, or to the work to be performed hereunder or the specifications accompanying the same shall affect its obligations on this bond, and it does hereby waive notice of any change, extension of time, alterations or addition to the terms of the contract or to the work or to the specifications. Fire Station No. 3 Concrete Removal and Replacement Cont. No. 40031 Page 7 of 8 City Attorney Approved 9/27 /16 PWM18-51GS In the event that Contractor is an individual, it is agreed that the death of any such Contractor shall not exonerate the Surety from its obligations under this bond. Executed by CONTRACTOR this /p-£11::- day f /,> /-r<J ":.'3t7c_ 20 17 0 _...,.,~v_r~ 1.., /-----' ...J....f--' CONTRACTOR: ;t.Ef{oN ({)NST4ier1CYJ &'1R/AI ~ 1NC. (name of Col')tractor) ' By:_fi.....__t_~....__~_-. -l_1 ;L_-L;_· --~--- (sign here) fobEO:r' /~e,~fY (print name here) ~ f'/lfN!fGee (title and organization of signatory) By: ______________ _ (sign here) (print name here) (title and organization of signatory) Executed by SURETY this 26th day of __ S_e...._pt_e_m_be_r _______ , 20 17 . SURETY: Philadelphia Indemnity Insurance Company (name of Surety) 251 S. Lake Avenue, Suite 360, Pasadena, CA 91101 (address of Surety) (626)639-1325 (telephone number of Surety) By: Matthew J. Coats (printed name of Attorney-in-Fact) (attach corporate resolution showing current power of attorney) (Proper notarial acknowledgment of execution by CONTRACTOR and SURETY must be attached.) (President or vice-president and secretary or assistant secretary must sign for corporations. If only one officer signs, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering that officer to bind the corporation.) APPROVED AS TO FORM: CELIA A. BREWER City Attorney By ~ ~ Deputy ityAttorney Fire Station No. 3 Concrete Removal and Replacement Cont No. 40031 Page 8 of 8 City Attorney Approved 9/27 /16 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 ------i A notary public or other officer completing this certificate verifies only the identity of the individual who signed the I document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of ____ o_ra_n_ge _______ _ On __ S_E_P __ 2_6 __ 20_17_ before me, ___ S_um_m_e_r _L._Re_y_es_, N_o_ta_ry_P_ub_lic _______ _ Date Here Insert Name and Title of the Officer personally appeared _____ M_att_h_e_w_J_. C_o_a_ts ____________________ _ Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. J «/ Notary Public · California z 1 t,1 , Orange County z z \ Commission # 2158864 ~ L~~~l Place Notary Seal Above I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. /\ Signature ___ r...,_.____,,,__..,--------'e___.__,_,_,___,___/_ ----------------OPTIONAL---------------- Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: _____________ Document Date: _______ _ Number of Pages: ____ Signer(s) Other Than Named Above: ____________ _ Capacity(ies) Claimed by Signer(s) Signer's Name: ____________ _ Signer's Name: ____________ _ ~J Corporate Officer -Title(s): ______ _ ~J Corporate Officer -Title(s): ______ _ ' , Partner --; Limited ,--:: General 1_ Partner --Limited _-General ,:J Individual = Attorney in Fact '_j Individual = Attorney in Fact tJ Trustee -::-: Guardian or Conservator = Trustee ~: Guardian or Conservator ']Other: _______________ _ = Other: _____________ _ Signer Is Representing: _________ _ Signer Is Representing: _________ _ ©2014 National Notary Association· www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 PHILADELPHIA INDEMNITY INSURANCE COMPANY One Bala Plaza, Suite 100 Bala Cynwyd, PA 19004-0950 Power of Attorney 4426 KNOW ALL PERSONS BY THESE PRESENTS: That PHILADELPHIA INDEMNITY INSURANCE COMPANY (the Company), a corporation organized and existing under the laws of the Commonwealth of Pennsylvania, does hereby constitute and appoint Linda D. Coats and Matthew J. Coats of Coats Surety Insurance Services, Inc., its true and lawful Attorney-in-fact with full authority to execute on its behalf bonds, undertakings, recognizances and other contracts of indemnity and writings obligatory in the nature thereof, issued in the course of its business and to bind the Company thereby, in an amount not to exceed $25,000,000.00. This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of PHILADELPHIA INDEMNITY INSURANCE COMPANY on the 14tl' of November, 2016. RESOLVED: FURTHER RESOLVED: That the Board of Directors hereby authorizes the President or any Vice President of the Company: (I) Appoint Attorney(s) in Fact and authorize the Attorney(s) in Fact to execute on behalf of the Company bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof and to attach the seal of the Company thereto: and (2) to remove, at any time, any such Attorney-in-Fact and revoke the authority given. And, be it That the signatures of such officers and the seal of the Company may be affixed to any such Power of Attorney or certificate relating thereto by facsimile, and any such Power of Attorney so executed and certified by facsimile signatures and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. IN TESTIMONY WHEREOF, PHILADELPHIA INDEMNITY INSURANCE COMPANY HAS CAUSED THIS INSTRUMENT TO BE SIGNED AND ITS CORPORATE SEAL TO BE AFFIXED BY ITS AUTHORIZED OFFICE THIS 14rn DAY OF NOVEMBER, 2016. (Seal) Robert D. O'Leary Jr., President & CEO Philadelphia Indemnity Insurance Company On this 14tl' day of November, 2016, before me came the individual who executed the preceding instrument, to me personally known, and being by me duly sworn said that he is the therein described and authorized officer of the PHILADELPHIA INDEMNITY INSURANCE COMPANY: that the seal affixed to said instrument is the Corporate seal of said Company: that the said Corporate Seal and his signature were duly affixed. Notary Public: residing at: Bala Cynwyd, PA (Notary Seal) My commission expires: Januai:y 8, 2018 I. Edward Sayago. Corporate Secretary of PHILADELPHIA INDEMNITY INSURANCE COMPANY, do hereby certify that the foregoing resolution of the Board of Directors and this Power of Attorney issued pursuant thereto on this 14tl' day of November, 2016 are true and correct and are still in full force and effect. I do further certify that Robert D. O'Leary Jr., who executed the Power of Attorney as President, was on the date of execution of the attached Power of Attorney the duly elected President of PHILADELPHIA INDEMNITY INSURANCE COMPANY, In Testimony Whereof I have subscribed my name and affixed the facsimile seal of each Company this /&-tf, day of 5.-,dk. 20 / 't-- Edward Sayago, Corporate Secretary PHILADELPHIA INDEMNITY INSURANCE COMPANY CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT ;\ notan· public or other officer completing this certificate verifies onh-the identity of the indi,-idual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Riverside -------------- On ID{! Dill who prcwed to me on the of satisfactory cc to be the person(s) whose name(s) is/ arc subscribed to the within instrument and acknowledged to me that he/she/ they cx<:cutcd the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entin· upon behalf of which the person(s) acted, executed the instrument. I certify under Penalty of Perjury under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS MY HAND AND OFFICIAL SEAL. (Notan-Seal) OPTIONAL INFORMATION T/Je atkt1ol!'ltr/,l',IJll'III m11tai11ed ll'ithi11 !hie dom1J1c11t is i11 ,1tconla11ce ll'ith C11!i/omir1 !all'. .·-111)' cerlijitale of ack1101v!er/,l',fllll'l!I pnfomml ll'ilhi11 !he S!ale of G,/Jfomia s/Ja!I 11.r1· !he pn,cedil(~ Jl'ordi1\/l, pm:w,111! to (,J;·il Code .redio11 11 X9. An ;icknowledg- ment cannot be ;iffixed to ;i docun1ent sent b_v mail or otherwise delivered to a notary public, including electronic me;ins, whereby the signer did not person.11/y appear before the 110t.1ry public, even if the signer is known by the nowry public. In addition, the correct not,irial wording can only be signed ,md .~ealed by a notary public. The seal and signature c;innot be affixed to a docwnent without the correct nourial wording. DESCRIPTION OF ATTACHED DOCUMENT :\un1l1l'·r of Pages ____ _ (Including ackn<lw!edgn1ent) Document Date ---------------- ;VlMXV H.WARDALE 925.786.8909 wwv,.TntallyNoca~'.nct CAPACITY CLAIMED BY SIGNER lndiYidual Corporate ( )fficcr Partner 1\ttornc\·-In-Fact Trustee ( )ther: KEETCON-01 MARD ACORD' CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYYYY) ._____... 10/05/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License# 0525512 CONTACT NAME: Teague Insurance Agency, Inc. wgN~o, Ext) (619) 464-6851 I FAX (A/C, NoJ:(619) 668-4715 4700 Spring St., #400 iicfJ~ss: info@teagueins.com La Mesa, CA 91942-0275 INSURER(Sl AFFORDING COVERAGE NAIC# INsuRERA :Associated Industries 23140 ~- INSURED INsuRERB :American Fire & Casualty 24066 Keeton Construction Co., Inc. INsuRERc: Topa Insurance Comoanv c/o 18031 41635 Enterprise Circle No. #A INsuRERD :State Com oensation Insurance Fund 35076 Temecula, CA 92590 INSURERE: Travelers Property Casualty Company of America 36137 INSURER F: COVERAGES CERTIFICATE NUMBER· REVISION NUMBER· THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOROTHERDOCUMENTWITH RESPECTTOw--llCHTHIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES_ LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. -- 11Nff TYPE OF INSURANCE ~.?£>~ ~.';{~~ POLICY NUMBER POLICY EFF ,i3T6%Y~~' LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 f---=i CLAIMS-MADE 0 OCCUR DAMAGE TO RENTED 100,000 X AES102050106 02/28/2017 02/28/2018 PREMISES !Ea occurrence I $ f--- f---MED EXP IAnv one oersonl $ PERSONAL & ADV INJURY $ 1,000,000 f---2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ Fl DPRO DLOC 2,000,000 POLICY JECT PRODUCTS -COMP/OP AGG $ OTHER $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIM IT 1,000,000 f---IEa accident\ $ X ANY AUTO BAA56405114 03/12/2017 03/12/2018 BODILY INJURY !Per oersonl $ f---OVvNED ~ SCHEDULED f---AUTOS OflcY ~ AUTOS BODILY INJURY (Per accident) $ HIRED NON-OW,JED (PR,,~~~c~Je~8AMAGE $ f---AUTOS ONLY f---AUTOS ONLY ~ C X UMBRELLA LIAB ~ OCCUR EACH OCCURRENCE $ 5,000,000 ~--XL660278806 02/28/2017 02/28/2018 s,oocf,ooo EXCESS LIAB CLAIMS-MADE AGGREGATE $ -- DED I X I RETENTION$ 10,000 $ D WORKERS COMPENSATION X I ~f~TUTE I I OTH- AND EMPLOYERS' LIABILITY ER Y/N X 300005817 01/01/2017 01/01/2018 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE D E L EACH ACCIDENT $ PrXf~~ifd~~~~'R~ EXCLUDED? N/A 1,000,000 EL DISEASE EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERAT'ONS below EL DISEASE POLICY LIMIT $ 1,000,000 E Equipment 6605395X682 03/12/2017 03/12/2018 Limit 300,000 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Fire Station No. 3 3465 Trail Blazer Way Carlsbad, CA 92010 The City of Carlsbad, its officials, employees and volunteers are included, when required by written contract, as additional insured with primary/non-contributory wording with respects to general liability and waiver of subrogation with respects to workers compensation per the attached policy form *30 day notice of Cancellation applies for all policies CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Carlsbad THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1635 Faraday Avenue Carlsbad, CA 92008 AUTHORIZED REPRESENTATIVE I i'1 ·l(,~tc J A,l(. ACORD 25 (2016103) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD \ POUCY NUMBER: AES1020501 01 COMMERCIAL GENERAL LIABILITY NX GL 009 08 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTING INSURANCE (THIRD-PARTY) This endorsement modifies insurance provided under the foilowing: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE ------------------~··-'---------------------------~ Third Party: All persons or organizations where required by written contract with the Named lnsJred I I --------~~---····_/ {Absence of a specificaliy"narned Third Party above means that the or-ovis-io:'1sof this eridorsernent apply as ~equlred by ~-vritten contractual agreement with any Third Party for whom you are performing work.) Paragraph 4. of SECTION IV: COMMERCIAL GENERAL UABILITY CONDITIONS is replaced by the following: 4. Other Insurance: Wtth respect to the n1ird Party shown above, this insurance is primary and non-contributing. Any and all other valid and co!!ectabls insurance available to such Third Party in respect of work performed by you under written contractual agreements wit11 said Third Party for loss covered by this policy, shaH in no Instance be considered as primary. co-insurance, or contributing insurance. Rather, any such other ,nsurance shall be considered excess over and above the insurance provided by t11is policy. NX GL 009 08 09 Page 1 of 1 Includes copyrighted material of Insurance Services O:'fice, Inc,, with its permission VpoucY NUMBER: AES1020501 01 / COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -COMPLETED OPERATIONS This endorsement modifies insurance provided under tr1e following: i COMt.;1ERC!,.e,..L GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additio11al Insured Person(s} Or Ornanization(s): Location And Description Of Completed Operations All persons or organizations where written contract with the Named Insured requires an additional In" sured with completed operations. This form does not apply to your work on ureslden~ tial property1'. tnformation reauired to comolete this Schedule, if not shown above, will be shown in the Declarations. Section It -Who ls An Insured is amended to include as an additional insured the person(s) or organization(s) shown 1n the Schedule, but only with respect to Habiity for "bodily injury" or "property dam- age·• caused, in whole or ln part, by "your work" at the location designated and described in the sched- ule of this endorsement perfonned for that additional insured and included in the ''products-completed operations hazard''. CG 20 3707 04 © ISO Properties, Inc., 2004 Page 1 of 1 D COMMERCIAL GENERAL LIABILITY CG 20 33 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II -Who Is An Insured is amended to include as an additional insured any person or or- ganization for whom yo1.1 are performing operations when you and such person or organization have agreed in writing in a contract or agreement that sL1ch pe(son or orga11iz:ation be added as an addi- tional insured 011 your policy. Such person or or- ganfzation is an additional insured only with re- spect to liability for "bodily injury", ';property damage" or "personal and advertising injury" caJsed, in whole or in part, by: 1. Your acts or omissfons; or 2. The acts or omissions of those acting on your be:>1alf; in the performance of your ongoing operations tor the additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are complet- ed. B. With respect to the insurance afforded to thE'~e additionai insureds, the following additional exclu- sions apply: This insurance does not apply to: 1. "Bodily injury", "croperty damage" or ''per$onal and advert,sing injury" arising out of the tender- 'ng of, o, the fail-ire to render, any profession~i! architec.tural, engineering or surveying ser- vices, including: a. The preparing; approving, or failing to pre- pare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifica- tions: or b. Supervisory. inspect1oi'1, architectural or engineering acHvities 2. "Bodily injury" or "properfy damage" occt1rrlng after: a. All· work, including mater:als, parts or equipment furnished in connection with such work, on the project {otller than ser-· vice, maintenance or repairs) to be per-· formed by or on behalf of the additional in- sured( s) at the location of the covered operatfons has been completed; or b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontrac~ tor engaged in performing operations for a principal as a part of the same project. CG 2033 0704 © ISO Properties, Inc., 2004 Page 1 of 1 D STATE ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION BLANKET BASIS BROKER COPY COMPENSATION lf\l'SIJRANC5 FUNO HOME OFFICE SAN FRANCISCO ALL EFFECTIVE DA TES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME EFFECTIVE JANUARY 1, 2017 AT 12.01 A.M. AND EXPIRING JANUARY 1, 2018 AT 12.01 A.M. KEETON CONSTRUCTION CO INC 41635 ENTERPRISE CIR N STE A TEMECULA, CA 92590 WE HAVE THE RIGHT TO RECOVER OUR PAYMENTS FROM ANYONE LIABLE FOR AN INJURY COVERED BY THIS POLICY. WE WILL NOT ENFORCE OUR RIGHT AGAINST THE PERSON OR ORGANIZATION NAMED IN THE SCHEDULE. THIS AGREEMENT APPLIES ONLY TO THE EXTENT THAT YOU PERFORM WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU TO OBTAIN THIS AGREEMENT FROM US. THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE 2.00% OF THE TOTAL POLICY PREMIUM. SCHEDULE PERSON OR ORGANIZATION ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER JOB DESCRIPTION BLANKET WAIVER OF SUBROGATION 3000058-17 RENEWAL SP 1-75-34-78 PAGE 1 OF NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: ~!:5C JANUARY 5, 2017 Ii~~~ .di~~~~ PRESIDENT AND CEO 2572 SCIF FORM 10217 (REV.7-2014) OLD DP 217 1